The CEMACH report reviewing Diabetes in pregnancy found that two thirds of women
had suboptimal preconception care. One of the underlying issues was failure of health
professionals to provide appropriate care such as preconception advice and a higher
dose of folic acid. One of the other major findings was poor documentation of pre-pregnancy
counselling. Suboptimal pre-conception preparation is associated with poor pregnancy
outcomes. Women with pre-existing diabetes have an increased risk of miscarriage,
fetal congenital anomaly and perinatal death. Women need to be prepared pre-pregnancy
to ensure that both they and their babies have the safest, healthiest pregnancy
and birth possible. Health care professionals should strive to empower women to
make their experience of pregnancy and childbirth a positive one, by providing information,
advice and support. It is important to explain that risks can be reduced but not
eliminated.

In November 2010 a request was made of DiPAG to develop 'Preconception Notes'
following the West Midlands Diabetes and Pregnancy Clinical Education Meeting (24th
November 2010).

The notes were launched in May 2012 following a region-wide pilot, consultation
with members of the Diabetes in Pregnancy Advisory Group (DiPAG) and feedback from
clinical practice and users.